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BMA chairman Dr Hamish Meldrum said: 'The bulk of what Darzi is proposing means closing down traditional GP surgeries.'

A key proposal in Lord Darzi's report, published in August, was the development of large polyclinics that would effectively close surrounding general practices.

The BMA's response was that the investment in new buildings and staff would not be cost-effective and would increase the distance patients had to travel.

Dr Meldrum said: 'Despite the government wishing to provide more care closer to home, it is likely that for most people in London, the polyclinic would actually be further away than their existing local GP surgery.

'The public still like local practice and the personalised care it gives them.'

It would be better to invest in expanding existing GP services rather than imposing costly, unproven polyclinics, he said.

The BMA warned the Darzi report failed to acknowledge the vast impact polyclinics would have on working hours of doctors. The concept of routine GP services being provided out-of-hours would stretch resources and affect quality of in-hours service, as GPs would require additional screening, X-ray, and laboratory staff to make it worthwhile.

Dr Meldrum criticised the DoH's consultation process, saying the citizen juries used by the 'Our NHS, Our Future' review were 'stage-managed events'.

Consultation should be an ongoing process between clinicians and the public, said Dr Meldrum.

Both the BMA and the GPC have complained that despite the DoH's 'hate campaign' about access aimed at them through the media, there has been no communication to resolve the situation.

'The best way to engage people is not through complaining about them through the media,' said Dr Meldrum.

For example, he said, five years ago the BMA suggested the idea of dual registration to improve access, but the DoH rejected the idea. Now it is one of the suggestions being made to GPs through the media.

'There are practical issues, to do with costs, electronic records and double prescribing. Come and talk to us about it,' he Dr Meldrum.

NHS London, which commissioned the Darzi report, has announced that every London PCT will consult on the plans until November 2007.

Polyclinic plan

• GPs to move into polyclinics of up to 10 practices.
• Polyclinics to house GPs, consultants, X-rays, ultrasound, blood tests and dialysis.